This application is a revision of R21 AG033796-01, which was most recently reviewed by ZRG1 HOP-L (90) in October 2008. The revision clarifies the conceptual component and research design, and adds Dr. Norman Giesbrecht of the Centre for Addiction &Mental Health as a consultant on provincial alcohol policies and the selection of instrumental variables. Little is known about longitudinal patterns of alcohol use among older adults. Moreover, there are few if any data regarding associations between longitudinal measures of alcohol consumption and morbidity in an aging population. This information is highly relevant to public health because most older adults consume alcohol. However, it is unclear what (if any) amounts of alcohol are safe for routine use in this population. For example, the National Institute on Alcohol Abuse and Alcoholism suggests that for older individuals, alcohol use should be no more than one drink per day. Conversely, researchers supported and/or employed by the National Institute on Aging recently suggested that the alcohol use guidelines should be the same for older as for younger adults (no more than two drinks per day). Needed now is evidence to inform development of guidelines regarding alcohol use for older individuals. Inconveniently, many if not most studies examining relationships between alcohol consumption and mortality are based on drinking behavior reported at baseline. Few projects have used patterns of alcohol consumption over time to predict mortality. Moreover, there is little if any information about connections between longitudinal patterns of alcohol use and measures of morbidity such as health-related quality of life or health care utilization. It has also been difficult to address possible reverse causation in which health status can influence alcohol consumption. The proposed project will address these issues by analyzing the Canadian longitudinal National Population Health Survey. This nationally representative data set includes twelve years of detailed self-reported information about alcohol use. The database also addresses diet, physical activity, and smoking as well as numerous other health determinants. Each two-year cycle of the survey includes health-related quality of life information as well as data on hospitalization and long-term care placement. This project will use the longitudinal data to (a) describe patterns of alcohol consumption over time among participants who were 50 years or older at baseline, (b) assess the relationships between longitudinal alcohol use and self-reported hospitalization, (c) analyze associations between longitudinal drinking patterns and long-term care placement, (d) study connections between longitudinal drinking patterns and health-related quality of life, and (e) examine relationships between longitudinal alcohol use patterns and mortality. The results will provide important information about relationships between longitudinal alcohol consumption and health-related outcomes for older adults. These results, in turn, can be used to develop guidelines regarding alcohol use in an older population. PUBLIC HEALTH RELEVANCE: This project will use data from the Canadian longitudinal National Population Health Survey to examine the relationship between patterns of alcohol consumption and health outcomes, including institutionalization and mortality among adults aged 50 and older. Information from this study will be of considerable relevance to public health as guidelines for alcohol use among older adults are updated.